and clinics and “making taxpayers pay for the treatment for which Kaiser is responsible,” a class action claims in Alameda County Court. Parents claim Kaiser refuses to cover the most effective treatment for childhood autism and even “prohibits clinicians from creating diagnostic evaluations” that might force Kaiser to give that treatment.
“Kaiser prohibits clinicians from creating diagnostic evaluations with specific treatments for ASD [autism] that families might use to seek treatment from Kaiser,” the complaint states. The parents sued Kaiser Foundation Health Plan and the Permanente Medical Group of Northern California.
They claim: “Kaiser issues boilerplate form denials of the only treatment used almost exclusively for ASD, Applied Behavioral Analysis (‘ABA’). Using a variety of pretexts and invalid excuses, Kaiser does not pay for ABA, even where that is the recommended and most effective treatment.”
Parents accuse Kaiser Permanente “of systematically denying essential health care services to disabled children with autism and pervasive developmental disorders – collectively referred to herein as ‘ASD’ or ‘autistic children.’ Notwithstanding reported annual revenues of $33 billion, Kaiser implements and enforces a multi-faceted, unlawful corporate policy calculated to avoid the cost of providing effective treatment to autistic children. Kaiser implements this policy through unfair tactics that include sham excuses, deliberate delay and other attempts to avoid its lawful obligations. The direct and often devastating consequence of Kaiser’s policy is to delay or deny medical treatment necessary to autistic children during a critical window of opportunity for intervention, to deny full and equal access to health care services to children with disabilities who desperately need it and to treat children disabled with autism differently from children with other forms of illness.”
Kaiser demands that the disabled children and their parents “seek those services from publicly funded school districts and regional centers for people with developmental disabilities, thus directly making taxpayers pay for the treatment for which Kaiser is responsible,” the complaint states.
Plaintiffs’ lead attorney is Anna Levine with Disability Rights Advocates.